Female athletes have a higher rate of anterior cruciate ligament (ACL) injuries than male athletes; however, the role of age in mediating this injury risk has not been explored. The purpose of this study was to characterize the relationship between age and sex in predicting ACL injury in the pediatric population.Prepubescent boys are more likely to sustain an ACL injury than prepubescent girls.Descriptive epidemiological study.Level 4.Data were collected from the Statewide Planning and Research Cooperative System database for the state of New York from 1996 to 2016. The database was queried for patients aged ≤19 years who had been diagnosed with an ACL tear using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 844.2 or the ICD-10 (10th Revision) codes S83.512A/S83.511A/S83.519A. Patient age and sex at time of ACL injury diagnosis were recorded. Chi-square analysis was used to compare the frequency of ACL injury between groups, with statistical significance set atP < 0.05.A total of 20,128 patients aged ≤19 years were diagnosed with an ACL tear (10,830 males, 9298 females; male:female, 1.16:1). In all, 129 patients aged <12 years sustained an ACL tear (85 boys, 44 girls; male:female, 1.93:1), and 19,999 of those patients were aged 12 to 19 years (10,745 males, 9254 females; male:female, 1.16:1). Chi-square analysis demonstrated a significant relationship between sex and age group (P < 0.006). Additional analysis revealed that female athletes were most at risk for ACL injury from ages 12 to 16 years, with 4025 male and 5095 female athletes sustaining ACL injuries in this group (male:female, 1:1.27; P < 0.0001).Prepubescent boys (aged <12 years) are more likely to sustain an ACL injury than same-aged female peers.This study demonstrates that the risk of ACL injury varies with age and sex throughout childhood and adolescence, further guiding treatment and prevention for these pediatric athletes.
Objectives: This study sought to determine associations between mFI-5 score and 30-day adverse outcomes after arthroscopic meniscectomy. Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried to identify all patients who underwent arthroscopic meniscectomy using Current Procedural Terminology (CPT) codes 29880 and 29881. Patients were included between 2005 and 2009. Patients were included if they were 50 years old or older. The mFI-5 score was calculated for each patient using variables present in NSQIP. Multivariate logistic regression models were utilized to identify the associations between mFI-5 scores and 30-day rates of overall complications, readmissions, reoperations, and mortality. Results: 41,102 patients were included. This included 21,102 patients with an mFI-5 score of 0, 15,438 with a score of 1, 4,641 with a score of 2, and 265 with a score of 3 or higher (3+). 388 patients experienced a complication, 275 experienced readmission, 4,675 experienced reoperation, and 9 experienced mortality within 30-days of surgery. Regression revealed that an mFI-5 score of 3+ was associated with an increased risk of overall complications (OR: 3.9; CI: 2.0-7.8; p<0.001). An mFI-5 score of 1 and 2 was associated with an increased risk of reoperation (OR: 1.2; CI: 1.1-1.3; p<0.001) (OR: 1.2; CI 1.1-1.3; p<0.001). An mFI-5 score of 1 (OR: 2.1; CI: 1.6-2.8; p<0.001), 2 (OR: 2.3; CI: 1.6-3.4), and 3+ (OR: 14.7; CI: 8.2-26.1; p<0.001) were all predictive of readmission. No mFI-5 score was predictive of mortality. Conclusions: mFI-5 scores were predictive of adverse outcomes within 30-days of arthroscopic meniscectomy, especially overall complications and readmissions. Further research is warranted into the development of patient risk stratification tools as well as on the impact of patient comorbidities on the rates of subsequent reoperations and mortality. Patients should be counseled on the increased risk of adverse events presented by medical comorbidities and should be optimized in regards to chronic conditions.
